Instructions for Fire Safety Plan in Office Buildings NYC Fire Department

The following information should be used while preparing or revising a Fire Safety Plan: Prepare Fire Safety Plan exactly as set by the guidelines with all information as requested. Attach to the Fire Safety Plan: 1. Copy of the most recent Certificate of Occupancy or Temporary Certificate or Occupancy or Schedule A if building is

under construction. 2. Copies of the representative floor plans including basement(s) meeting criteria as listed below. 3. Copy of riser diagram for standpipe and/or sprinkler system for the building (see requirements on p.2 ) 4. Copies of any other supporting documents like request for variance(s). The following are the requirements for the acceptable representative floor plans: Submit architectural type of representative floor plans including basement and sub-basement not larger than 11x17. Plans must be of good print quality and show the entire floor areas. Include a site plan of the building. Indicate northerly direction along with surrounding buildings and streets, cross streets and F.D. apparatus access roads. Additionally, indicate the premise foot print and Standpipe and Sprinkler Siamese Connection locations and location of building occupant assembly areas.

Locate the following on floor plans: a. Exits. b. Evacuation routes (the route must be shown by displaying the permanent partitions which create the

corridors* used for exit access**. Additionally, provide hatching or a red line throughout the route.) c. Fire barriers***. d. Areas of refuge**** e. Stairs with letter designation. f. Access and convenience stairways g. Elevator bank letter and car number designations same as listed in Building Information Form. h. Fire Command Station. i. Fire warden phones. j. Manual fire alarm boxes (pull stations) k. Standpipe hose outlets. l. Sprinkler and standpipe system control valves. m. Any part of the building not protected by sprinkler system. n. Emergency power generator and fuel supply o. Show legend for all symbols and abbreviations used. p. Indicate Northerly direction. q. In-Building Relocation Areas: where applicable (optional) Submit Fire Safety Plan or revised Fire Safety Plan, complete with all attachments, for review by Fire Department. Do not submit individual sheets.

This cover sheet and Instruction Sheet Numbers 2 and 3 of the guide MUST NOT be included in the plan. * New 2008 NYC Building Code Sec. BC 1002 Definitions.

** New 2008 NYC Building Code Sec. BC 1002 Definitions. *** New 2008 NYC Building Code sec. BC 706.

**** New 2008 NYC Building Code Sec. BC 1002 Definitions.

FDNY Office FSP Instructions Sheet 1 of 3 Rev. 9 30 09

FDNY Office FSP Instructions Sheet 2 of 3 Rev. 9 30 09

Disapproved and Conditionally Accepted Fire Safety Plans must be resubmitted within 30 days from the date of the letter disapproving or conditionally accepting them. Any disapproved plan not resubmitted within six months is considered abandoned and will require a new filing fee.

Fire Safety Plan Riser Diagram

Following are the requirements for an acceptable Standpipe and /or Sprinkler System Riser Diagram: Locate the following:

a. Gravity Tanks, indicating the total capacity and fire reserve. b. Pressure Tanks, indicating the capacity. c. Risers, indicating the size and locations. d. Siamese connections, indicating locations. e. Fire Pump, (if applicable) indicating output (gpm) and automatic or manual. f. Booster Pump (special service pump), indicating output (gpm). g. All cross connections. h. City water main supply. i. Fill line and house pump. j. You may show legend to indicate all symbols used, for example

• Check valves (upper and lower) and control valves • Pressure reducing valves ( PRV) • All riser sectional valves • Dry pipe valves • Pre-action sprinkler valves • Roof manifold • Fire hose racks on all floors. • Sprinkler floor control valves

Note: Diagram must be of good print quality showing the entire system

and using professionally standard symbols and legend.

The diagram may Not exceed 11x 17 inches.

INSTRUCTION FOR PROCESSING

FORM NAME: FIRE SAFETY PLAN AND GUIDELINES FORM NUMBER: INTDOC 9/09

FDNY Office FSP Instructions Sheet 3 of 3 Rev. 9 30 09

PURPOSE OF FORM To provide Class E Office Buildings with the forms which must be submitted and be accepted by the FDNY.

WHO SHOULD USE THIS DOCUMENT Property Owners, Fire Safety Directors and other management staff required to file Fire Safety plans.

TO SUBMIT COMPLETE APPLICATION, BY MAIL: FDNY Bureau of Fire Prevention 9 Metrotech Center Brooklyn, NY 11201 Attn: RM 3W - 6 OR WALK IN 9 METROTECH CTR – 1ST FLR. At rear of FDNY HQ building. Ask for Window 8 Business hours are Monday through Friday

9:00AM - 12:00PM & 1:00PM - 3:00PM.

PAYMENT INFORMATION Is payment required? Yes $210 If so, when? With submission

FOR FURTHER QUESTIONS, CONTACT: FDNY- BFP ATTN: Emergency Planning and Preparedness Group 718-999-1512

SPECIAL INSTRUCTIONS All plan submittals must be accompanied by a form TM-1 available at: http://nyc.gov/html/fdny/pdf/cof_study_material/tm_1.pdf

FDNY Office FSP Guide Sheet 1 of 18 Rev. 9 30 09

FIRE SAFETY PLAN AND GUIDELINES - OFFICE BUILDINGS

Purpose

• To establish a method of systematic, safe and orderly evacuation of an area or building by and of its occupants in case of fire or other emergency, in the least possible time, to a safe area or by the nearest safe means of egress; also the use of such available fire appliances (including sounding of alarms) as may have been provided for the controlling or extinguishing of fire and the safeguarding of human life.

• Objective

To provide proper education as part of continuing employee indoctrination and through a continuing written program for all occupants, to assure the prompt reporting of fire, the response to fire alarms as designated, and the immediate initiation of fire safety procedures to safeguard life and contain fire until the arrival of the Fire Department.

1. Building Address:_____________________________ Name of Building_____________________ Borough and Zip Code: ________________________ Telephone Number: __________________

2. Fire Safety Director

2.1 Name/Job Title: _________________________________________ 2.2 Certificate of Fitness # Expiration date: ___________ 2.3 Regularly assigned location: _________________________________ 2.4 How is he/she notified when at regular location - include business or cell phone #s if

applicable: ___________________________________ 2.5 How is he/she notified when not at regular location - include business

or cell phone #s if applicable: ____________________________________ 2.6 Normal working days and hours: _______________________________________ 2.7 Duties of Fire Safety Director – Verbatim as per Appendix A

3. Deputy Fire Safety Director

3.1 Name/Job Title: _________________________________________ 3.2 Certificate of Fitness # Expiration date: ____________ 3.3 Regularly assigned location: _________________________________ 3.4 How is he/she notified when at regular location-include business or cell phone # if

applicable: ___________________________________ 3.5 How is he/she notified when not at regular location-include business

or cell phone # if applicable: ____________________________________ 3.6 Normal working days and hours: _______________________________________ 3.7 Duties of Deputy Fire Safety Director – Verbatim as per Appendix B

4. Fire wardens and Deputy Fire Wardens. (Ref.#1)

4.1 Are the names on Organizational Charts for each floor and/or tenancy (Yes/No):_______ 4.2 Submit typical completed Organizational Chart for Fire Drill and Evacuation assignment. 4.3 Duties of Fire Wardens and Deputy Fire Wardens– Verbatim as per Appendix C

5. Building Evacuation Supervisor

5.1 Name/Job Title: _________________________________________ 5.2 Regularly assigned location: _________________________________________ 5.4 How is he/she notified when at regular location-include business or cell phone # if

applicable: ___________________________________

FDNY Office FSP Guide Sheet 2 of 18 Rev. 9 30 09

5.5 How is he/she notified when not at regular location -include business

or cell phone # if applicable: ____________________________________ 5.6 Normal working days and hours: _______________________________________ 5.7 Duties of Building Evacuation Supervisor – Verbatim as per Appendix D

6. Fire Brigade (Ref.#2)

6.1 Submit a completed Organizational Chart for Fire Brigade for each shift, naming person in charge, and his/her title in the building.

6.2 List standards of selection from building employees:______________________________ ________________________________________________________________________

6.3 How are they notified? Include business or cell phone # if applicable: ________________ 6.4 How are they notified when they are not at their regularly assigned locations? Include

business or cell phone # if applicable: ______________________ 6.5 Means of responding – indicate location they go to: ______________________________

________________________________________________________________________ 6.6 Duties of Each member of Fire Brigade -Verbatim as per Appendix E

7. Occupant Instructions

7.1 Distribution of instructions to all tenants, tenants’ employees and building employees- See

Appendix F

8. Evacuation Drills

8.1 Frequency of drills- indicate start date and frequency: ____________________________ 8.2 How announced: _________________________________________________________ 8.3 Participation. Who participated? __________________________________________ How?: __________________________________________________________________ 8.4 Controls and supervision: __________________________________________________ 8.5 Where is current record of drills kept: ________________________________________

9. Fire Command Station

9.1 Location (also show location on Floor plan): ___________________________________ 9.2 Requirements:

9.2.1 Adequate Illumination (Yes/No): ______________ 9.2.2 Adequate communication to mechanical equipment room, elevator control room,

each floor (list devices for each location: _______________________________________________________ _______________________________________________________

9.2.3 Copy of Fire Safety Plan (Yes/No): __________________________ 9.2.4 Copy of Building Information Form (Yes/No): _________________ 9.2.5 Representative floor plans (Yes/No): _________________________

Plans must include all aspects as listed on instruction sheet (a-i).

10. Signs

10.1 Signs at elevator landing with Floor diagrams (Yes/No): ____________________ 10.2 Floor numbering in stair enclosure (Yes/No): ___________________ 10.3 Stairway identification on occupancy side of stair door (Yes/No): _________________ 10.4 Elevator identification– (where posted): _____________________________________ 10.5 Stair Re-entry– (where posted – list re-entry floors): ___________________________

_____________________________________________________________________

FDNY Office FSP Guide Sheet 3 of 18 Rev. 9 30 09

11. Fire Prevention and Fire Protection Program for the building – See Appendix G 12. Building Information Form – See Appendix H

13. Representative Floor Plans (architectural type,11x17 max. ,B&W ) – See Appendix I 14. Fire Safety Plan general preparation guideline– See Appendix K

15. Prepared/revised by (provide contact information): __________________________________

__________________________________________________________________________________ 15.1 Date prepared: _________________________ 15.2 Date revised: _________________________

FDNY Office FSP Guide Sheet 4 of 18 Rev. 9 30 09

Appendix

A. Fire Safety Director Duties B. Deputy Fire Safety Director Duties

C. Fire Wardens and Deputy Fire Wardens Duties and Organizational Chart for Fire Drill and Evacuation

Assignment

D. Building Evacuation Supervisors Duties E. Fire Brigade Duties, and Organizational Chart for Fire Brigade

F. Occupant Instructions G. Fire Prevention and Fire Protection Program

H. Building Information Form

I. Representative Floor Plan

J. Evacuation Procedure

K. Fire Safety Plan

FDNY Office FSP Guide Sheet 5 of 18 Rev. 9 30 09

APPENDIX A. Fire Safety Directors Duties

1. Be familiar with the written Fire Safety Plan providing for fire drill and evacuation procedure in accordance with Fire Prevention Code.

2. Select qualified building service employees for a Fire Brigade and organize, train and supervise such Fire Brigade.

3. Be responsible for the availability and state of readiness of the Fire Brigade. 4. Conduct fire and evacuation drills. 5. Be responsible for the designation and training of a Fire Warden for each floor, and

sufficient Deputy Fire Wardens for each tenancy in accordance with Fire Department rules.

6. Be responsible for a daily check for the availability of the Fire Warden and Deputy Fire Warden, and see that up-to-date organizational charts are posted.

NOTE- If the number of Fire Wardens and Deputy Fire Wardens in the building is such that it is impractical in individually contact each one daily, a suggested method to satisfy the requirement is to make provisions for the Fire Warden, or a Deputy Fire Warden, in the absence of the Fire Warden, to notify the Fire Safety Director when the Fire Warden, or required number of Deputy Fire Wardens are not available. In order to determine the compliance by the Fire Warden and Deputy Fire Warden when this method is used, the Fire Safety Director shall make a spot check of several floors each day.

7. Notify the owner or other persons having charge of the building when any designated individual is neglecting his responsibilities contained in the Fire Safety Plan. The owner or other person in charge of the building shall bring the matter to the attention of the firm employing the individual. If the firm fails to correct the condition, the owner or person in charge of the building shall notify the Fire Department.

8. In the event of a fire, shall report to the Fire Command Station to supervise, provide for and coordinate:

(a) Insure that the Fire Department has been notified of any fire or fire alarms. (b) Manning of the fire Command Station. (c) Direction of evacuating procedures in the Fire Safety Plan. (d) Reports on conditions of fire floor for information for Fire Department on their

arrival. (e) Advise the Fire Department Chief in charge in the operation of the Fire

Command Station.

9. Be responsible for the training and activities of the Building Evacuation Supervisor. B. Deputy Fire Safety Directors Duties

1. Subordinate to the Fire Safety Director 2. Perform duties of Fire Safety Director in his absence

C. Fire Wardens and Deputy Fire Wardens

1. The tenant or tenants of each floor shall, upon request of the owner or person in charge of the building, make responsible and dependable employees available for designation by the Fire Safety Director as Fire Warden and Deputy Fire Warden.

2. Each floor of a building shall be under the direction of a designated Fire Warden for the evacuation of occupants in the event of fire. He shall be assisted in his duties by a Deputy Fire Warden. A Deputy Fire Warden shall be provided for each tenancy. When the floor area of a tenancy exceeds 7,500 square feet, a Deputy Fire Warden shall be assigned for each 7,500 square feet of part thereof.

3. Each Fire Warden and Deputy Fire Warden shall be familiar with the Fire Safety Plan, the location of the exits and the location and operation of any available fire alarm system.

FDNY Office FSP Guide Sheet 6 of 18 Rev. 9 30 09

4. In the event of a fire, or fire alarm, the Fire Warden shall ascertain location of the fire, and direct the evacuation of the floor in accordance with directions received and the following guidelines:

(a) The most critical areas for immediate evacuation are the fire floor and floors

immediately above. Evacuation from the other floors shall be instituted when instructions from the Fire Command Station or conditions indicates such action. Evacuation should be via uncontaminated stairs. He shall try to avoid stairs being used by the Fire Department. If this is not possible, he shall try to attract the attention of the Fire Department personnel before such personnel open the door to the fire floor.

(b) Evacuation to two or more levels below the fire floor is generally adequate. He shall keep the Fire Command Station informed regarding his location.

(c) Fire Wardens and their Deputies shall see that all occupants are notified of the fire, and that they proceed immediately to execute the Fire Safety Plan.

(d) The Fire Warden on the fire floor shall, as soon as practicable, notify the Fire Command Station of the particulars.

(e) Fire Wardens on the floor above the fire shall, after executing the Fire Safety Plan, notify the Fire Command Station of the means being used for evacuation and any other particulars.

(f) In the event that stairways serving fire floor and/or floors above are unusable due to contamination or cut-off by fire and/or smoke, or that several floors above fire involving large numbers of occupants must be evacuated, consideration may be given to using elevators in accordance with the following:

1. If the elevators servicing his/her floor also services the fire floors, they

shall not be used. However, elevators may be used if there is more than one bank of elevators, and he is informed form the Fire Command Station that one bank is unaffected by the fire.

2. If elevators do not service the fire floor and their shafts have no opening on the fire floor; they may be used, unless otherwise directed.

3. Elevators manned by trained building personnel or firemen also may be used.

4. In the absence of a serviceable elevator the Fire Warden shall select the safest stairway to use for evacuation on the basis of the location of the fire and any information received from the Fire Command Station. The Fire Warden shall check the environment in the stair prior to entry for evacuation. If it is affected by smoke, an alternate stair shall be selected, and the Fire Command Station notified.

5. The Fire Warden shall keep the Fire Command Station informed of the means being employed for evacuation by the occupants of his floor.

(g) Determine that an alarm has been transmitted.

5. Organizational Chart for Fire Drill and Evacuation Assignment

See Example Ref.#1 A chart designating employees and their assignments shall be prepared and posted in a conspicuous place in each tenancy and on each floor of a tenancy that occupies more than one floor and a copy shall be in the possession of the Fire Safety Director.

FDNY Office FSP Guide Sheet 7 of 18 Rev. 9 30 09

6. Have available an updated listing of all personnel with physical disabilities who cannot

use stairs unaided. Make arrangements to have these occupants assisted in moving down the stairs to 2 or more levels below fire floor. If necessary to move such occupants to still lower levels during the fire, move them down the stairs to the uppermost floor served by an uninvolved elevator bank and then remove to street by elevator. Where assistance is required for such evacuation, notify Fire Safety Director.

7. Provide for fire warden identification during the fire drills and fires, such as using armbands, etc.

8. Assure that all persons on the floor are notified of fire and all are evacuated to safe areas. A search must be conducted in the lavatories to assure all are out. Personnel assigned as searchers can promptly and efficiently perform this duty.

9. Check availability of applicable personnel on Organizational Chart and provide for substitute when position on chart is not covered.

10. After evacuation, perform a head count to assure that all regular occupants know to have occupied the floor have been evacuated.

11. When alarm is received, the Fire Warden shall remain at a selected position in the vicinity of the communication station on the floor, in order to maintain communications with the Fire Command Station and to receive and give instruction.

FDNY Office FSP Guide Sheet 8 of 18 Rev. 9 30 09

ORGANIZATIONAL CHART FOR FIRE DRILL AND EVACUATION

(Typical)

FIRE SAFETY DIRECTOR

_____________________________

DEPUTY FIRE SAFETY DIRECTOR

_____________________________

FLOOR

FIRE WARDEN

______________________________

DEPUTY FIRE WARDENS _____________________ ______________________ _____________________ _______________________

SEARCHERS

MALE FEMALE _____________________ ______________________

ALARM TRANSMISSION: Any person discovering fire or smoke should without delay cause the transmission of an alarm of fire by any of the following methods available. 1. Telephone (Call 911 to report a fire) 2. Street Alarm Box (list location): _________________________________________________ 3. Building Fire Alarm. If building fire alarm is not connected to central station, also notify Fire

Department. Indicate if alarm is connected to central station: ________________________________________

NOTE: Also notify Fire and/or Deputy Fire Wardens that Alarm has been transmitted.

BOROUGH TELEPHONE NUMBERS: 212-999-2222 -- MANHATTAN 718-999-3333 -- BRONX 718-999-4444 -- BROOKLYN

718-999-5555 -- QUEENS 718-999 -- 6666 STATEN ISLAND

Date prepared: _________________ Ref.#1 Date revised: __________________

FDNY Office FSP Guide Sheet 9 of 18 Rev. 9 30 09

D. Building Evacuation Supervisors Duties

A Building Evacuation Supervisor is required at all times when there are occupants in the building and there is no Fire Safety Director required to be on duty in the building. 1. Capable of directing the evacuation of the occupants as provided by the Fire Safety Plan. 2. During fire emergencies, the primary responsibility of the Building Evacuation

Supervisor shall be to man the Fire Command Station, and the direction and execution of the evacuation as provided in the Fire Safety Plan. (a) The Building Evacuation Supervisor’s training and related activities shall be under the direction of the Fire Safety Director in accordance with these rules, and the Fire Safety Plan. Such activities shall be subject to Fire Department control.

E. Fire Brigade Duties

1. On receipt of an alarm for fire the Fire Brigade shall:

(a) Report to the floor below the fire to assist in evacuation and provide information to the Fire Command Station.

(b) After evacuation of fire floor, endeavor to control spread of fire by closing doors, etc. (c) Attempt to control the fire until arrival of the Fire Department, if the fire is small and

conditions do not pose a personal threat. (d) leave one member on the floor below the fire to direct the Fire Department to the fire

location and to inform them of conditions. (e) On arrival of the Fire Department the Fire Brigade shall report to the Fire Command

Station for additional instructions. (f) Have a member designated as Alarm Box Runner, who shall know the location of the

nearest street Fire Alarm Box, and be instructed in its use. Such member shall immediately, upon receipt of information that there is a fire or evidence of fire, go to the street alarm box, transmit an alarm and await the arrival of the fire department and direct such department to the fire.

FDNY Office FSP Guide Sheet 10 of 18 Rev. 9 30 09

ORGANIZATIONAL CHART FOR FIRE BRIGADE

Shift hours: from: _______________ to: ________________

Minimum staffing requirement: (4) members each Fire Brigade.

Names of Members of Fire Brigade * FSD/DFSD not to be used as fire brigade* Person in Charge – Title ____________________________________ Member assigned to assist in evacuation ____________________________________ ____________________________________ ____________________________________ Members assigned to attempt to ____________________________________ control small fires. Minimum of two persons. ____________________________________ ____________________________________ Alarm box runner for transmitting alarm. (if applicable) ____________________________________ Back up runner. (if applicable) ____________________________________ Member assigned to ____________________________________ communicate conditions to Fire Command Station. Member assigned to the floor ____________________________________ below fire to direct Fire Department. Date Prepared: __________________________________ Date Revised: ___________________________________ Ref.#2

F. Occupants Instructions

(a) The applicable parts of the approved Fire Safety Plan shall be distributed to all tenants of the building by the building management when the Fire Commissioner has approved the Fire Safety Plan

(b) The applicable parts of the approved Fire Safety Plan shall then be distributed by the tenants to all their employees and by the building management to all there building employees.

(c) All occupants of the building shall participate and cooperate in carrying out the provisions of the Fire Safety Plan.

G. Fire Prevention and Fire Protection Program (see note)

1. A plan for periodical formal inspections of each floor area, including exit facilities, fire extinguishers and housekeeping shall be developed.

A copy of such plan shall be submitted Information that can be included is as follow:

FDNY Office FSP Guide Sheet 11 of 18 Rev. 9 30 09

(a) At the start of the day a check of each exit shall be required to determine

that self-closing doors are in the closed position but are not illegally locked in any manner.

(b) No obstructions shall be permitted in corridors or aisle spaces (c) Necessary exit signs and lights where required, shall be lighted and in good

condition. (d) All personnel shall know the location and operation of fire extinguishers.

The Maintenance shall be controlled by the Fire Safety Director. (e) Poor housekeeping is a fire breeder. All establishments shall avoid

accumulation of combustible debris. 2. Provision shall be made for the monthly testing of communication and alarm systems.

Note: This is a guideline only. Plan must be specific to applicable building

FDNY Office FSP Guide Sheet 12 of 18 Rev. 9 30 09

H. Building Information Form

Building Address: ________________________ Zip Code: _______________

1. Owner or person in charge of the building.

Company: ________________________ Name of representative:________________

Address including ZIP Code: ______________________________________________

Business telephone No.: _______________________________

2. Fire Safety Director (FSD) and Deputy Fire Safety Director (DFSD).

Name Business/Cell No.

FSD: __________________________________ ______________________________

DFSD: __________________________________ ______________________________

DFSD: __________________________________ ______________________________

DFSD: __________________________________ ______________________________

DFSD: __________________________________ ______________________________ Add sheets if necessary

3. Certificate of Occupancy : Attach copy of current C of O or temporary C of O or

Letter of No Objection from Buildings Department or Affidavit of No C of O issued

By Building Department If under construction attach copy of Schedule A.

Location where C of O is posted in the building: _______________________________

4. General description of the building:

Building Height in feet: ________ No. of stories: ______ No. of basements: _______

Area (Length X Width) at ground level: _________ x ________ = (sf)

Class of construction as listed on current C of O: ______________________________

5a. Stairs Information: Number, type and location of fire stairs and/or fire towers,

and/or fire escapes and/or utility/access stairs. Include alphabetical letter

identification.

Letter designation Type Location Levels (floors) served ____ _________ ______________ _________________________________

____ _________ ______________ _________________________________

____ _________ ______________ _________________________________

____ _________ ______________ _________________________________

____ _________ ______________ _________________________________ Add sheets if necessary

FDNY Office FSP Guide Sheet 13 of 18 Rev. 9 30 09

Building Information Form cont’d

5b. List re-entry floor numbers and indicate if fail-safe on re-entry floor is installed.

_____________________________________________________________________

_____________________________________________________________________

6. Number of, type and location of Horizontal exits or other Areas of Refuge.

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

7. Elevator and/or escalator information:

Number of elevator banks and elevators: _________________---_________________

Elev. Bank No. of Pass. or Operation Designation Cars Freight (Man/Auto) Levels (floors) served _________ ______ _________ __________ ___________________________

_________ ______ _________ __________ ___________________________

_________ ______ _________ __________ ___________________________

_________ ______ _________ __________ ___________________________

Elev. Bank Firemen Service Elevator Machine Designation (Yes/No) Room Location __________ ___________ ____________________________________________

__________ ___________ ____________________________________________

__________ ___________ ____________________________________________

__________ ___________ ____________________________________________ Add sheets if necessary

Number of escalators: ___________________ Escalator Levels (floors) served __________ __________________________________________

__________ __________________________________________ Add sheets if necessary

8. Fire Alarms System and Central Station Information.

Type of Fire Alarm: ____________________________________________

Brand: Model: __________________

Name of Central Station: ______________________________________

9. Communications systems other than Class E alarm system communications like

walkie-talkies, telephones, etc

____________________________________________________________________________

FDNY Office FSP Guide Sheet 14 of 18 Rev. 9 30 09

Building Information Form cont’d 10. Standpipe system information:

Location of riser: ______________________________ Size of riser: __________________

Location of riser: ______________________________ Size of riser: __________________

No. of gravity tanks: ________ Location(s): _____________________________________

Capacity of gravity tank(s) (gals): __________________ Fire Reserve (gals): ___________

No. of pressure tanks: ________ Location(s): ____________________________________

Capacity of pressure tank(s) (gals): _______________________________

No. of fire pumps: ______ Location/output(s) (gpm): _____________________

_________________________________________________________________________

Type(s) of pump(s) (automatic or manual): ______________________________________

_________________________________________________________________________ Number and Location(s) of Siamese connection(s):

_________________________________________________________________________

Name of Certificate of Fitness holder: __________________________________________

Certificate No.: ____________________________ Expiration date: __________________

11. Sprinkler system information:

Primary water supply: __________________ Secondary water supply: ________________

Is this a combination of Standpipe/Sprinkles system? (Yes/No): _________

Areas protected: ____________________________________________________________

_________________________________________________________________________

No. of gravity tanks: ________ Location(s): _____________________________________

Capacity of gravity tank(s) (gals): _______________________________

No. of pressure tanks: ________ Location(s): ____________________________________

Capacity of pressure tank(s) (gals): _______________________________

No. of fire pumps: ______ Location/output(s) (gpm): ______________________________

Type(s) of pump(s) (automatic or manual): __________________________________

Number and Location(s) of Siamese connection(s):

_________________________________________________________________________

Name of Certificate of Fitness holder: __________________________________________

Certificate No.: ____________________________ Expiration date: __________________

12. Special Extinguishing systems information. Example- Halon, Pre-Action , Range

hood (Ansul), Deluge – Include Location(s). Confirm if tied into fire alarm system.

____________________________________________________________________________

____________________________________________________________________________

FDNY Office FSP Guide Sheet 15 of 18 Rev. 9 30 09

Building Information Form cont’d

13. Average number of persons normally employed in building.

DAYTIME: ____________ NIGHTTIME: ____________

14. Number of people with Disability employed in building.

List Names , locations and Telephone Numbers of disabled people.

Name ______________ LOCATION __________Telephone Number ______

Name ______________ LOCATION __________ Telephone Number ______ Add sheets if necessary

15. Number of Persons normally visiting building.

DAYTIME: ______________ NIGHTTIME: ____________

16. Service Equipment such as:

(a) Electric Power:

Primary – Street name where power enters the building: ________________

Auxiliary -Auxiliary Generator (Yes/No): __________

Location of generator: __________________________Type of fuel: _______ List capacity and location of the tank in Item 18

(b) Emergency Lighting:

Type Locations.

_______________ __________________________________________ Add sheets if necessary

(c) Heating:

Type: ____________________________________

Fuel: _____________________________________

Location of heating unit: __________________________________________ Add sheets if necessary

(d) Ventilation:

Emergency means of exhausting heat and smoke (Yes/No): ______________

Smoke purge system (Yes/No): ________ Smoke shaft (Yes/No): _________

Do the windows open on any floors? (Yes/No): __________

If YES, list locations where windows open: ___________________________

______________________________________________________________

Are keys required? (Yes/No): _____ If YES, list where located: ___________

Type of key (1620 or 2642) if required: __________________

(e) Air Conditioning System – Be specific:

Central A/C (Yes/No): ______ If YES, Size and Locations of Units

_____________________________________________________________

Through floor duct work (Yes/No): _______

If YES, list floors: ______________________________________________

FDNY Office FSP Guide Sheet 16 of 18 Rev. 9 30 09

Building Information Form cont’d Location of Area Served Supply Fan _________________ __________________________________________ _________________ __________________________________________

Add sheets if necessary Package units on each floor (Yes/No): _______ Unit Compressor HP Location Area Served ID or Tonnage _______ _________ ______________ ______________________ _______ _________ ______________ _____________________

Add sheets if necessary (f) Refuse storage and disposal (Yes/No): ___________

If Yes, list type and location: _______________________________________

(g) Firefighting equipment and appliances, OTHER than standpipe and

sprinkler systems.

_____________________________________________________________________

(h) Other pertinent building information and the locations.

Example – roof set-back, utility shafts, cross bridges, tunnels etc.

___________________________________________________________

___________________________________________________________

17. Alterations and repair operations

If any and the protective and preventive measures necessary to safeguard such

operations with attention to torch operations. (Torch operator must have valid

Certificate of Fitness).

____________________________________________________________________________

____________________________________________________________________________

18. Storage and use of flammable solids, liquids and/or gases (including Fuel storage tanks). Be specific-Type/quantity and location. ____________________________________________________________________________ ___________________________________________________________________________

19. Special Occupancies in the building:

Example: Place of Public Assembly-studios, cafeterias, retail stores, auditoriums,

theaters, etc.(include listing of locations)

____________________________________________________________________________

____________________________________________________________________________

FDNY Office FSP Guide Sheet 17 of 18 Rev. 9 30 09

Building Information Form cont’d 20. Number and location of electrical transformers containing liquid poly-chlorinated

biphenyles (PCB).

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

I. Representative Floor Plans.

Submit copy of floor plans for ALL floors, INCLUDING Basements and roof meeting requirements listed on the instruction sheet.

J. Evacuation Procedure (if deemed necessary)

(a) The most critical areas for immediate evacuation are the fire floor and the floors immediately above. Evacuation from the other floors shall be instituted when instructions from the Fire Command Station or conditions indicate such actions. Evacuation should be via uncontaminated stairs. Occupants shall try to avoid stairs being used by the Fire Department. If this is not possible,

occupants shall try to attract the attention of the Fire Department personnel before such personnel open the door to the fire floor.

(b) Evacuation to two or more levels below the fire floor is generally adequate. (c) The Fire Safety Director shall see that all occupants are notified of the fire and that they proceed immediately to execute the Fire Safety Plan. (d) The Fire Brigade members on the fire floor shall, as soon as practicable, notify the Fire Command

Station of the particulars. (e) In the event that stairways serving fire floor and/or floor above are unusable due to contamination

or cut-off by fire and/or smoke, or that several floors above the fire involving large numbers of occupants must be evacuated, consideration may be given to using the elevators in accordance with the following: (ee) Elevators serving fire floors shall not be used. However, elevators may be used if there is more than one bank of elevators and the Fire Command Station is notified that one bank is unaffected by the fire. (ff) If elevators do not service the fire floor and their shafts have no openings on the fire floor, they may be used, unless otherwise directed by authorized personnel. (gg) Elevators manned by trained building personnel or firemen may also be used. (hh) In the absence of a serviceable elevator occupants shall select the safest stairway to use for evacuation on the basis of the location of the fire and any information received from the Fire Command Station. Occupants shall check the environment in the stair prior to entry for evacuation. If it is effected by smoke, an alternate stair shall be selected.

(f) The Brigade shall keep the Fire Command Station informed of the means employed for evacuation of the occupants.

FDNY Office FSP Guide Sheet 18 of 18 Rev. 9 30 09

K. Fire Safety Plan

In planning evaluate the individual floor layouts, the population of floors, the number and kinds of exits the zoning of the floor by area and occupants. Determine the movement of traffic by the most expeditious route to an appropriate exit and alternative route for each zone, under fire conditions one or more exits may not be useable. ** This format for Fire Safety Plan is to be used in the preparation of the Fire Safety Plan** Nothing contained in the Fire Safety Plan format is to be construed as all-inclusive. All rules and other requirements are to be fully complied with. Attach additional pages if necessary, have pages numbered.